Erectile dysfunction in the scope: a scientific look into the issue
The inability to have a full sexual intercourse in males could be the result of organic or functional changes in the central or peripheral nervous reflex path, as well as explained by the pathological condition of the endocrine system. Erectile dysfunction may be the result of functional diseases of the brain, in which for one reason or another, the link between the processes of excitation and inhibition is broken. This type of ED is referred to as cortical. Among its reasons neurotic states should be listed first of all.
It is accompanied by all sorts of conditions of insecurity and fear of sexual act. In the event of predominance in the cerebral cortex of cortical inhibitory processes erectile dysfunction may manifest as decrease in sexual excitability (decreased sexual desire and orgasm, while maintaining an erection), erectile function (erection disappearing before sexual intercourse, no ejaculation, but sexual desire is normal), ejaculatory function (normal libido and erection, but the absence of orgasm and ejaculation are observed).
Cortical erectile dysfunction with the prevalence in the cerebral processes of excitation manifests as rapidly advancing erection, but premature ejaculation at the beginning of any sexual intercourse takes place. Ejaculation is not always accompanied by an erection.
Spinal erectile dysfunction is a consequence of the primary lesion of the organic or functional sexual centers, embedded in the spinal cord. Functional disturbances of these centers are often observed, accompanied by increased excitability of erectional and ejaculatory centers (when erection is normal, but rapid premature ejaculation occurs), increase of excitability of ejaculational and decreased excitability of erectional centers (rapid ejaculation with weakened erection), decrease of the excitability of both centers (violations vary widely – from excitation, close to the norm, to its complete disappearance of erection and complete absence of ejaculation), the absence of a decrease in excitability of the ejaculatory centers in the normal function of erection (libido and erections are normal, but there is no ejaculation and orgasm).
Erectile dysfunction associated with genital disease, can have three forms, depending on the impact of three factors: endocrine testicular function disorders, diseases of the prostate and seed tubercle and purely mechanical injuries (because of malformations, various injuries or disease of the penis may occur).
The first of these forms of ED has endocrine origin: as a result of reduced production of male sexual hubbub comes weakening of sexual desire. Impaired function of the testicles is possible congenital (hypoplasia of the testes – hypogonadism), acquired in childhood (bilateral orchitis, especially after the pigs, followed by scarring and shrinkage of the testicles) or longer later in life (orchitis, trauma testicles, as well as the result of age-related changes in the elderly and old age).
In the event of the second form of ED the leading role is played by diseases of the prostate and seed tubercle associated with either deviations from normal sexual activity (sexual excesses, interrupted or artificially tightened intercourse, excessive masturbation), infections or other reasons (stagnation due to sedentary, insufficiently active lifestyle, and so on).
Prostate and seminal tubercle play an important role in sexual function, controlled mainly through neuromuscular reflex mechanisms; both prostate and seminal colliculus have abundant networks of nerve plexus, components and receptors.
Here you can not say that the acute prostatitis, even its complicated forms, has no effect on sexual function, while in chronic prostatitis with prolonged inflammation, congestion, degenerative and scarring in the prostate affect existing nerve endings that conduct impulses to the centers of erection and ejaculation, and spinal cord stimulation is transmitted to these centers. The result is the depletion of these centers, and sexual dysfunction: first, premature ejaculation, while maintaining an erection, and after that, the weakening of the erection itself.
During chronic prostatitis cortical or psychogenic ED may occur, because the associated disease brings discomfort and pain in the area of genitals fix the attention of the patient, causing fear of sexual intimacy, lack of confidence in their abilities, fear of being insolvent, and in this regard, cause actual sexual dysfunction.
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In older age patients adverse effects on sexual function can be the result of prostate adenoma. Developing deep in prostatic tissues, adenomatous nodes displace the periphery and squeeze the breast tissue, which leads to dysfunction of the prostate, and after that, to its atrophy.
The third form of erectile dysfunction is caused by abnormalities or diseases of the penis, which by virtue of a purely mechanical reasons make it impossible to introduce it into the vagina.
For young men (under 30) psychogenic ED is more common; for the middle-aged (30-50 years old) – neuroreceptor-spinal ED, associated with prostate disease, are observed more often, tubercle seed centers and the depletion of the spinal cord that control erection and ejaculation; for men over 50 years old – ED has endocrine nature and is largely explained by age-related decrease in hormonal function of the testes.